PIP Claims Representative- Gainesville, FL

This job is with Florida Farm Bureau which is the Florida state office for Southern Farm Bureau Casualty Insurance Company, and we currently have an opening for a PIP Claims Representative to work in Gainesville, FL. This position is responsible for managing and adjusting medical insurance claims under Personal Injury Protection and/or Medical Payments coverage. In this role you will ensure timely and accurate processing of  claims while maintaining compliance with regulatory requirements and company standards.  Starting salary of $40,500.  We offer many benefits including health, dental, vision, PTO, Extended Illness Leave, Pension and matching 401K.

SUMMARY: responsible for managing and adjusting medical insurance claims under Personal Injury Protection and/or Medical Payments coverage. The PIP Claims Rep ensures timely and accurate processing of claims while maintaining compliance with regulatory requirements and company standards.

ESSENTIAL DUTIES AND RESPONSIBILITES: Include the following. Other duties may be assigned.

• Review, investigate, and process PIP and/or Medpay claims in accordance with applicable laws and policy provisions.
• Determine coverage eligibility, verify medical necessity, and assess reasonableness of charges.
• Communicate with claimants, medical providers, attorneys, etc. to gather necessary documentation to resolve claims.
• Maintain detailed and accurate claim files and documentation.
• Provide clear and empathetic communication to claimants and stakeholders.
• Address inquiries and resolve issues promptly and professionally.
• Prepare reports and summaries for management as needed.
• Regular and predictable attendance is required.

EDUCATION and/or EXPERIENCE:

• H.S. Diploma is required
• Must obtain Adjuster's license in 6 months
• Customer service experience
• Familiarity with medical terminology & treatment protocols

SKILLS/ABILITY

• Proficient in English written and Verbal communication skills
• Possesses strong technical aptitude
• Proficient PC skills
• Good math skills
• Ability to type approximately 50wpm